Snape Darlene A, Morgan Myfanwy, Ridsdale Leone, Goodacre Steve, Marson Anthony G, Noble Adam J
Department of Psychological Sciences, University of Liverpool, Liverpool, UK.
Institute of Pharmaceutical Science, King's College London, London, UK.
Epilepsy Behav. 2017 Mar;68:177-185. doi: 10.1016/j.yebeh.2017.01.006. Epub 2017 Feb 16.
Epilepsy affects around 1% of the UK population; 40% of whom experience two or more seizures annually. However, most Emergency Department (ED) visits by people with epilepsy (PWE) are clinically unnecessary. Evidence highlights that with correct training, seizures can be safely managed by patients and their families within the community. Arguably therefore, PWE who frequently visit the ED might benefit from a self-management intervention that improves their own and their families' confidence and ability in managing seizures. Currently, no such intervention is available for PWE attending the ED. A collaborative approach (patients, carers, health professionals) was adopted to develop a patient-focused, self-management intervention. An existing group-based seizure management course, offered by the Epilepsy Society, was adapted. Collaborative feedback was sought via a base-line document review, one-to-one semi-structured interviews, and focus group discussions. The applied framework provided a systematic approach from development through to implementation. Participant feedback overall was extremely positive. People with epilepsy who visit the ED reported a positive view of epilepsy seizure first aid training and associated educational materials. Their feedback was then used to develop the optimized intervention presented here. Strengths and perceived barriers to successful implementation and participation, as well as the practical and psychosocial benefits, were identified. We describe the developed intervention together with the process followed. This description, while being project-specific, provides a useful template to assist in the development of interventions more generally. Ongoing evaluation will determine the effects of the training intervention on participants' behavior.
癫痫影响着约1%的英国人口;其中40%的人每年会经历两次或更多次癫痫发作。然而,癫痫患者(PWE)大多数前往急诊科(ED)就诊在临床上并无必要。有证据表明,经过正确培训,癫痫发作可由患者及其家人在社区内安全处理。因此可以说,频繁前往急诊科就诊的癫痫患者可能会从自我管理干预中受益,这种干预能提高他们自己及家人处理癫痫发作的信心和能力。目前,对于前往急诊科就诊的癫痫患者尚无此类干预措施。我们采用了一种协作方法(患者、护理人员、健康专业人员)来开发一种以患者为中心的自我管理干预措施。对癫痫协会提供的现有基于小组的癫痫发作管理课程进行了改编。通过基线文档审查、一对一的半结构化访谈和焦点小组讨论来寻求协作反馈。所应用的框架提供了一种从开发到实施的系统方法。总体而言,参与者的反馈非常积极。前往急诊科就诊的癫痫患者对癫痫发作急救培训及相关教育材料持积极态度。然后利用他们的反馈来开发此处展示的优化干预措施。确定了成功实施和参与的优势及感知到的障碍,以及实际和心理社会方面的益处。我们描述了所开发的干预措施以及所遵循的过程。此描述虽然是针对特定项目的,但提供了一个有用的模板,有助于更广泛地开发干预措施。持续评估将确定培训干预对参与者行为的影响。